Laserfiche WebLink
r <br /> STATE OF CALIFORNIA Do Not Fill In <br /> THE RESOURCES AGENCY �j <br /> OR1131NAL DEPARTMENT OF WATER RESOURCES l�2 9700-19 <br /> Filo*Ith DWRr <br /> WATER WELL DRILLERS REPORT State well No <br /> Other Well No. <br /> 1 OWNER: <br /> (111 -WELL LOG: i <br /> Name STATE OF CALIFORNIA Taaldrpth it. Depth of completedwclfj s nft. <br /> Address <br /> Farmation-Describe by corer,dwisc-ler,s$e of ineterlel,asd rirarrurr <br /> i <br /> it.to fr. <br /> (Z) LOCATION t' nn '�jO{ FM1!WELL: (l S Sail � <br /> CountySAN JOA U I N Owner s number.if any6 15 !„! <br /> ard -Pan <br /> Township,Range,and Sectio9 HIGHWAY 92 RIPON 15 40 San <br /> Durance from cities,tosds,rrilroads.etc. 40 49 Clay <br /> 49 107 Sand & 8' av <br /> ial <br /> (3) TYPE OF WORK (check): 107 12T Clay <br /> New Well ® Deeponing ❑ Reconditioning 11 Destroying ❑ 127 134 Sand <br /> It destr4ellorr,deimbr nsaterial and procedrare it;liern 11. 134 -150 5 <br /> (4) PROPOSED USE (check): (T) EQUIPMENT: <br /> Domestic ❑ Industrial ❑ Municipal ❑ Rotary <br /> Irrigation ® Test`VWell(] Other ❑ Cable ❑ <br /> Other <br /> (6) CASING INSTALLED: <br /> STEEL- OTHER. If gravel packed <br />�. SINGLE® 1]OVDLE❑ <br /> Gage Diameter <br /> I From '1'0 or of From To <br /> ft. ft. Diarn. Wall Bore it. ft. <br /> 20 <br /> 11 If <br /> I <br /> Sized oboe at wtil AAApInte Sire of gtarole <br /> Rwabe went we I djjrj ' <br /> (7) PERFORATIONS OR SCREEN: <br /> Yy of petfaradan a name of rerecn <br /> l <br /> Pcrf. Rows 6 <br /> From To per per Size <br /> fr. it. row fr. in. tin. <br /> Ful—fli woler - ' <br /> (9) CONSTRUCTION: <br /> I: <br /> Was a s9tfsce ttninry seal provided? Yrs 1`:0[] To what depth ft. � <br /> Weft sn uou snled against ilntian? <br /> yvtQ Na if It..nota depth of strata <br /> bretq ft.To it, <br /> }rnm ft.to ft. Work awnedEah 19 ,Gompleud 19 71 <br /> Method of wesling WELL DR]LLER'S STATEMENT: <br /> {9) WATER LEVELS: This well was drilled reader any jnrisdirtion and this report is tripe to the best <br /> of my knowfedgeaod befief, <br /> Depth st which waur wan Ant found,if known 29 it. <br /> Standing Ienl before perforating, if known ft- NAME' <br /> Sundio level after rfontine snd denelo inx it. <br /> (Perron,firm,or eorpatuian} lTyyrd or printed} <br /> (10) WELL 'PESTS: - Loc No 12396 Address <br /> s pomP urs Madel Yes •,ha b If yes,6y Whom? ,Oj <br /> tQc5tap <br /> d: gal-linin.with 61 it.drawdown after hrs. [St NIE <br /> f (Well Dr?Ifrr) <br /> empenture of water '�•• Was a ehaaieal anal sis mads? Yet Q( Na[] , <br /> Wat electric tog Made of well? Yrr'C]: No If yu,attach copy LlCensa fVo -76602 —Datad s 19 . <br /> SKETCH LOCATION OF WELL <br /> ON REVERSE SIDE E <br /> DWR laf; (RgV.9-88} t/{ ]61)p..9549-BB IOM Tit]PAD Car <br />